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What Do Rising COVID Cases in the U.K. Mean for the U.S. This Winter?

— Experts say several factors in the U.K. are contributing to a new uptick in infections

MedpageToday
A vaccination advertisement in the middle of a street in SOHO UK reserved for restaurant and bar tables.

As the U.K. grapples with a rise in COVID-19 cases -- for the first time since July -- experts said several factors need to be addressed to ward off further infections and hospitalizations.

They also noted that the urgent nature of the U.K.'s situation could contain signals for the U.S., as the U.K. has served as a harbinger of what's to come throughout the pandemic.

Earlier this week, amid the rise in cases, the NHS Confederation, which represents healthcare providers in the U.K., to introduce safety measures, such as mandatory face coverings in crowded and indoor spaces, to ward off a "winter crisis."

"By the Health Secretary's own admission we could soon see 100,000 cases a day and we now have the same number of weekly COVID deaths as we had during March, when the country was in lockdown. It is therefore incredibly concerning that he is not willing to take immediate action to save lives and to protect the NHS," said Chaand Nagpaul, MBBS, chair of the Council of the British Medical Association, in a .

"It's vital that the government does everything to ensure it is made as simple and easy as possible for people to receive their booster, or even their first and second jab, especially in groups where uptake is lower," he added.

Earlier this year, the U.K. saw early success with its COVID-19 vaccination efforts, and society opened back up, nearly completely. But now, people's eagerness to live life and do business with few restrictions, coupled with waning immunity from the vaccines, have complicated the U.K.'s recovery.

From February to May, the U.K.'s 7-day average for new cases declined from around 10,000 to 2,000. It remained below 10,000 through most of June, but then started to climb in July.

Since then, the U.K. has had a "persistently high number of daily cases," James Naismith, BSc, PhD, of the University of Oxford in England, told ֱ in an email. "This makes the U.K. more vulnerable to other effects, since the growth of cases in absolute terms is a matter of where you start."

As of October 20, U.K. government data showed that there were due to COVID-19 compared with less than 1,000 patients hospitalized in the early days of June. On October 21, were reported, which was relatively low, but still higher than earlier in the year.

As to what has contributed to the uptick in COVID-19 cases, Naismith cited the U.K.'s removal of most restrictions, as well as waning immunity from vaccines.

"More mixing of people" leads to "more spread of virus," Naismith said. And, "the return to school has driven a very large wave in secondary age school kids, with ."

Additionally, the U.K. -- like Israel -- is "seeing some evidence of waning immunity," Naismith added. "We know that a booster potently restores immunity."

Naismith further noted that the U.K. has been slow to vaccinate young adults, a group that has high rates of infection, and winter is coming, which will push people indoors to poorly ventilated spaces.

One factor that may not be as significant as its name suggests is the Delta Plus variant.

"The only new variants we will see are those that spread better than Delta," said Naismith.

Though Delta Plus "does appear to spread slightly faster," there is no evidence that it is more deadly, he added. A significant increase in transmissibility could cause problems in terms of overwhelming health systems, but Delta Plus is not a big jump over Delta.

Bill Hanage, PhD, an associate professor of epidemiology at Harvard University, concurred.

"It looks to have some advantage, but not a huge one," Hanage told ֱ in an email. "It's been around since July, and it's taken that long to reach [about] 10%, so it is not taking the world by storm."

Hanage reiterated that much of the current uptick in COVID-19 cases in the U.K. is being driven by infections in schoolchildren who are not vaccinated: "Schools have been open with very limited mitigation indeed. Schools offer a route for the virus into households. A lot of parents will have had [the AstraZeneca vaccine], which struggles to stand up to Delta. Vaccinating high school kids would be expected to help a lot."

The situation in the U.K. would suggest that mobilizing booster efforts is a priority, Naismith said. "The fall and winter in the U.S. may see further increases after a welcome drop," as people continue to choose to be unvaccinated.

Hanage also noted that the U.S. has a lower vaccination rate than the U.K. in older age groups.

Adjusted for population size, Hanage said that if the U.S. saw the same numbers that the U.K. is currently seeing, the U.S. would be at about 250,000 daily cases.

"Despite this, the U.K. (again corrected for population size) is seeing a fraction of the daily deaths reported in the U.S., which are still plateaued at about 1,500," he added. "If we saw that much infection in the U.S., the results would be far worse."

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    Jennifer Henderson joined ֱ as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.